Dáil debates

Thursday, 7 February 2019

Nurses and Midwives Industrial Action: Statements

I very much welcome the opportunity to discuss this matter. The industrial action taken by the Irish Nurses and Midwives Organisation, INMO, and the Psychiatric Nurses Association, PNA, is clearly creating significant challenges and disruption for the health service and more importantly, has created a worrying time for patients and their families. I acknowledge this is not an action nurses and midwives take lightly and that the situation must be resolved. The Government remains steadfast in wishing to resolve the matter.

There is no monopoly on political support for nurses. I am privileged, as Minister for Health, to meet incredible nurses and midwives on a daily basis. I also meet patients on a daily basis who remind me of the excellent work nurses do across this country. This is not a debate about who cares more for nurses. This is a debate about how one resolves an industrial relations dispute in the context of a public service stability agreement, which I believe most if not all parties in this House profess to support. It must be remembered by everyone in the House that the Government, and the unions, including those involved in the dispute, signed up to a three-year public service pay agreement. Honouring agreements does matter.

The public service pay agreement expressly prohibits cost claim pay increases during the lifetime of the agreement. That is what was signed up to, so it is within that space that a solution must be found. Deputies have already heard in this House how the public service pay agreement takes significant steps towards pay restoration. That agreement commits to seeing significant increases in pay by 2020, and nurses and midwives can expect to see their share of the increases beginning this year. Reductions for pay levels up to €50,000, which include a large proportion of the nursing and midwifery profession, will be fully unwound by the end of this year. That represents a wage increase of between 2% and 2.5%, on average, across the sector, with new entrants and lower-paid professionals benefitting the most from the changes. The Government is united in its support to unwind pay reduction measures introduced under financial emergency measures in the public interest, FEMPI, legislation. The agreement was sought in full co-operation and collaboration with public sector unions, including nursing unions.

We are eager to come to a fair and satisfactory solution for all parties involved that preserves the integrity of all elements of the agreement. That puts us in a difficult position in terms of how we reach a solution which respects the public service stability agreement and the other unions who represent other hard-working public servants who are not engaged in industrial action. There is an onus on those in this House who say that we should just support the claim being made by the nursing unions to answer the question to their constituents who work in other areas of the public service as to whether they believe they too should be treated equally in that regard.

However, just because something is difficult – this is clearly a difficult situation - does not mean that we give up. Far from it. There have been repeated attempts to resolve this dispute, none of which have borne fruit yet, but I stress the word "yet". I believe there are solutions to be found but it will require innovation and imagination on both sides. On Monday, my colleague, the Minister for Finance and for Public Expenditure and Reform, and I issued a statement on the current nursing dispute. The statement made it clear that the Government continues to be willing to engage in talks on the range of workplace-related issues to try to resolve the dispute. The statement called for immediate engagement in the context of the current dispute with relevant unions. Unfortunately, I regret that engagement has not taken place. The Workplace Relations Commission remains available to facilitate all the parties in that regard.

Issues of recruitment and retention in the health service, which unions have claimed are at the heart of the dispute, must be taken seriously. We fully accept that the numbers of highly-qualified nursing, midwifery and medical professionals leaving the country is an issue that requires to be addressed. That is why the Government engaged the Public Service Pay Commission to look at roles in the public sector where recruitment and retention had been identified as issues. If we did not take those issues seriously, we would not have set up a specific module of the Public Service Pay Commission to examine those issues in the health service. The commission itself features members with a wealth of experience working in trade union organisations including SIPTU, IMPACT and the Irish Congress of Trade Unions, ICTU. Nursing and midwifery were among the first of the professions investigated by the independent commission. The commission's findings were clear and they were published and accepted in full by the Government. The conclusion after in-depth assessment was the recruitment and retention issues were a cause of concern but that pay could not be found to be the one determining factor. It is a complex issue with many aspects and one that requires a range of solutions. That does not discount the equally clear actions recommended in the report that I, as Minister for Health, the HSE, and the Government are considering to improve staff retention and recruitment within the nursing and midwifery profession.

In addition to the benefits nurses and midwives can expect to receive from the unwinding of pay restrictions under the pay agreement, and the correction of salary scale issues for post-2011 new entrants, the Government has agreed to the commission's recommendations of a 20% increase in local and qualification allowances for nurses, as well as accelerated promotion for staff nurses to the senior staff nurse level. Despite the unions' recent rejection of the findings, the Government is hopeful that through further dialogue and clarification, these recommendations can be accepted and can be put into action this year for the benefit of nurses and midwives.

The industrial action taken by the unions is having a significant impact on hospitals and healthcare facilities. The decision to escalate the industrial action to include disability services was unwarranted. The industrial action taken by the unions is impacting in a real way. By the end of today's work stoppage more than 37,000 outpatient appointments will have been cancelled since the strike action commenced and it is expected that more than 6,000 inpatient and day-case appointments will have been cancelled. Those are not just numbers. Behind each case lies worry and concern for patients and their families.

Looking ahead to next week, a further three days of industrial action is planned, with more cancellations needed. In addition, the cumulative effect of the three days of industrial action will add to the stress on an already strained system. Members should be under no illusion that this is a dangerous situation and that patients would be put at risk.

While the disruption is creating a worrying time for many people, contingency plans have been activated by the HSE to ensure urgent life-saving care is maintained throughout this industrial action. I recognise that the unions are co-operating in terms of contingency planning in these regards. These plans are being modified and refined daily to ensure this essential coverage is delivered during this dispute.

I understand the strength of the unions' concerns and fully recognise that to have a first-class health service requires staff who have first-class support. It is regrettable the unions feel that pay reforms are not coming into action quickly enough but the proposed industrial action and ongoing industrial action are not the answer.

We are fully committed to coming to a satisfactory solution for all parties involved in accordance with the terms of the public service pay and stability agreement. I hear many people say that the solution can be found within the agreement. There is a duty on people to outline how exactly they would bring that solution about. Any solution to this dispute must be affordable and fair; affordable to the taxpayer but fair to all other hard-working public servants, including nurses in other unions who are working today and who have faithfully observed the parameters of the public service pay and stability agreement.

The stakes in this dispute are high. I mentioned recently that this situation is like a tightrope, and it is. The Government must maintain a responsible and prudent handling of our public finances, including public service pay, because without it, all future pay agreements may not only be at risk but may become unaffordable. To agree to the demands of the unions as they currently stand would tilt that handling of the public finances into an unsustainable spiral. This would damage our economy, our health service and ultimately public servants, including nurses, who we wish to support.

It is essential that industrial action comes to a halt as soon as possible. Our Government is sincere in its offer to want to talk and engage with nursing unions to reach a resolution to this dispute. I am confident this can be accomplished through further dialogue and engagement. I really hope after today's stoppage comes to an end that there is a real intensity of engagement as we work together to try to avoid further disruption.

I am sure many of us have had the opportunity to see nurses on the picket line. People have beeped their horns in support. What struck me as I passed were the chants I heard, proclaiming the need for safe staffing. While the key staff essential for running the services in the building behind them are outside on the picket line, there has to be a better way to do our business. I believe that the better way lies in the industrial relations machinery of the State, the Workplace Relations Commission, the Labour Court and not on the picket line. The solution will not be found here on the floor of the Dáil. The solution will be found using our industrial relations mechanism. We want to use that mechanism. We want to come to a solution. We want to find an innovative solution but we also want to honour an agreement that most parties in this House claim they fully support, which is the public service pay and stability agreement, and the commitment we gave to all our public servants, including nurses and midwives, under that agreement.